How traditional beliefs threaten young children’s lives

The belief that “Cala” causes malnutrition and that sesame oil is the treatment almost killed Nyibol.

Gabriel Reec
A mother holding her daughter
15 April 2020

The belief that a spell named cala make children malnourished and that an elixir can treat it, almost killed Nyibol.

The seven-month-old girl had been suffering from diarrhoea and vomiting for a longer period of time when her mother, Achol Diing took her to Gabat nutrition centre in Aweil. The screening area is a simple tukul with the ground covered with patterned plastic mats in green, red and yellow. On this day, as most days, the mats were filled with mothers and their children. Achol and Nyibol were waiting patiently on their turn.

While waiting, one of the other mother’s told Achol that her daughter was suffering from Cala and that she urgently needed cala treatment, which is a homemade sesame oil applied on the child’s body and put in the food. Achol took her daughter home and started working on the treatment. You might wonder what cala is, we’ll get back to that a bit later.

Nyibol didn’t respond well to the homespun medicine and she got thinner by the day. When her mother brought her back to Gabat nutrition centre a month later, her weight was only 4.5 kg and her upper arm circumference 9.3 cm, indicating she was suffering from severe acute malnutrition. The little girl was immediately admitted to the UNICEF supported nutrition programme where she is was treated with ready-to-use therapeutic food (RUTF)- our number one medicine against malnutrition. But Nyibol’s life was still in danger.

Before explaining what happened to Nyibol, let me explain what Cala is. Cala is believed to appear if a mother greets a widow whom had a lover while she was still married. When the mother and the widow greet, the evil spirit is transmitted to the mother’s body and is further given to her child through the breastmilk. The sign of the Cala is when the child is losing weight quickly, just like Nyibol did.

A malnourished child breastfeeding
A severely acute malnourished Nyibol is breastfeeding.

Nutrition workers came regularly to Nyibol’s house made out of grass and plastic sheets to check on her. They would often find Achol in tears. “I had lost hope, not a single thing seemed to help my daughter. I thought I had hours left with her.” Nybol’s eyes remained sunken with the look of an old woman, the little hair she had was brittle and the skin dry and too big for what was left on the inside. Despite given the RUTF her weight continued to drop. The now ten- month- old girl’s weight was the same as the average new-born, just 3.5 kg.

It is difficult to say exactly how far from her maker she was, but we are talking maximum days. Nyibol was admitted to a hospital where she was given medication for the vomiting and diarrhoea to stop. As soon as that was addressed, she started gaining weight again and was discharged and re-enrolled in the UNICEF supported nutrition programme. In just a few weeks her skin turned glossy, her arms filled out the skin, the hair was shiny again and the spark in her eyes was back. During a check up a month later, her weight was 4.9 kg and her upper arm circumference 10.9 cm- meaning she is not out of the woods yet but progressing well. She will need to stay on RUTF for several weeks until she has bounced back fully.

A child have her upper arm circumference measured
Nyibol on a check-up after being admitted to the nutrition programme

As the girl has been severely malnourished for a longer period of time during the critical brain development period, which is from the last trimester in mommy’s tummy to the age of two years, UNICEF is supporting the family with toys designed to stimulate the child’s brain to catch up with the time lost.

In 2020, UNICEF expect 1.3 million children in South Sudan to suffer from acute malnutrition, close to 300,000 of them will be severely affected such as Nyibol. Over 1,100 UNICEF supported nutrition centres across South Sudan will handle most of these cases and more than 9/10 will most likely make it. That said, more needs to be done to prevent children from getting malnourished in the first place. Denying children their right to health is not only affecting children directly, it will also affect the future of South Sudan. After all, these children are the future.

UNICEF's nutrition programmes are generously supported by the European Civil Protection and Humanitarian Aid Operations, ECHO.

a girl smiling
Nyibol will recover fully when her treatment is finalized.